Amanda Thacker (NPI# 1811421498, PAC ID# 4486929858) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.
| Nation Provider ID (NPI) | 1811421498 |
| PAC ID by PECOS | 4486929858 |
| Professional Enrollment ID | I20180314000015 |
| Full Name | Amanda Thacker |
| Organization Legal Name | LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS |
| Address |
N5241 Us Hwy 45 Watersmeet MI 49969-5115 |
| Phone Number | 9063584587 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | CHIROPRACTIC |
| Group Practice PAC ID | 2567629181 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| N5241 Us Hwy 45, Watersmeet, MI 49969-5115 | 9063584587 | LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS |
| Organization Legal Name | LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark P Brown | Physician Assistant | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Gregg C Pusateri | Optometry | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Jessica A Hoffman | Nurse Practitioner | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Daniel C Hadley | Family Medicine | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Patti M Paige | Nurse Practitioner | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Lisa A Meza | Physician Assistant | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Gary M Pusateri | General Practice | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Street Address |
N5241 US HWY 45 |
| City | WATERSMEET |
| State | MI |
| Zip | 49969-5115 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark P Brown | Physician Assistant | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Gregg C Pusateri | Optometry | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Jessica A Hoffman | Nurse Practitioner | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Daniel C Hadley | Family Medicine | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Patti M Paige | Nurse Practitioner | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Lisa A Meza | Physician Assistant | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Gary M Pusateri | General Practice | Lac Vieux Desert Band of Lake Superior Chippewa Indians | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Chelsie M Word | Physician Assistant | Lac Vieux Desert Tribal Council | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| Charissa Jeske | Clinical Social Worker | Lac Vieux Desert Tribal Council | N5241 Us Hwy 45, Watersmeet, MI 49969-5115 |
| City | WATERSMEET |
| Zip Code | 49969 |
| Specialty | CHIROPRACTIC |
| City + Specialty | WATERSMEET + CHIROPRACTIC |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.